Press Conference on Medicare Legislation

Federal News Service

HEADLINE: PRESS CONFERENCE ON MEDICARE LEGISLATION WITH: SENATE MAJORITY LEADER BILL FRIST (R-TN); SENATOR CHARLES GRASSLEY (R-IA); SENATOR MAX BAUCUS (D-MT); SENATOR JOHN BREAUX (D-LA); SENATOR SUSAN COLLINS (R-ME); AND SENATOR DIANNE FEINSTEIN (D-CA)

LOCATION: SENATE RADIO/TV GALLERY, THE CAPITOL, WASHINGTON, D.C.

BODY:
SEN. FRIST: Good morning. Today is an extraordinary, it's a fateful and a red letter day for seniors and, indeed, for all Americans. This legislation is consequential for all Americans, it's far-reaching for all Americans. It touches all of us in meaningful and truly remarkable ways.

It allows young people to save through personalized, tax-free health savings accounts; older people to access prescription drugs through the Medicare program for the first time in that wonderful program's history, but a program that has been deficit and that hasn't offered much in the way of preventive services, and hasn't offered outpatient prescription drugs, the most powerful tool in American medicine today, at all.

This bill is epical in the sense that it modernizes Medicare to 21st century standards, such as preventive care for things like heart disease and diabetes; for coordinated care and disease management, which is commonplace in the private sector, but is practically non- existent in Medicare today. And indeed, because it includes prescription drugs; prescription drugs for Alzheimer's, Parkinson's, coronary artery disease, chronic obstructive pulmonary disease, diabetes, and the list goes on-prescription drugs that in the past have been denied through the Medicare program to our seniors, but which will be there because of this legislation-bipartisan legislation from day one.

We've insisted in the United States Senate that this be bipartisan, and so it is with great satisfaction that we stand together in a bipartisan way, with a bipartisan vote, reflecting that spirit of cooperation and partnership from the outset.

SEN. GRASSLEY: Well, the president is ready to sign this bill, and I'm very happy to have him sign it.

But regardless of the legislation, I think the fact that this Congress has been able to deliver on the promises of both political parties over the last three elections is a very significant thing, because, you know, people tend to have some cynicism about political leaders. Sometimes we promise more than we should. This has been promised for a long period of time, and I'm glad that we were able to deliver on that promise, because we're going to have 40 million seniors and disabled people that shouldn't have to wait any longer for prescriptions as part of their Medicare coverage.

Medicare, as you know, is very much a part of the social fabric of America. That fabric, we've all recognized, has had a hole in it for a period of time, that hole being prescription drugs. We're improving and strengthening Medicare by plugging that hole in our safety net.

Seniors need access to affordable prescription drugs. We're giving it to them. Seniors need better Medicare programs with more choices and better benefits, and we're giving that to them. Seniors need to be able to keep the Medicare they have, if they like it, with no changes, and still get prescription drugs. We're giving that to them, with the right to choose.

Finally, seniors in rural states like mine of Iowa or rural states like represented up here need better treatment for Medicare reimbursement formulas, and we're giving that to them in a very dramatic way, by increasing reimbursements, so that rural areas will have the same quality of care that people in urban areas get.

So this is a great day for our seniors. I'm glad to be successful at this.

SEN. BAUCUS: It's a privilege to be a part of a great team effort here to pass legislation which means so much and touches so many people. Often we in the Congress, in passing legislation, know that the bill we're working on is important, but it's like a lot of other bills: it tends to affect some people and not some others.

This legislation directly affects all Americans, certainly seniors, but also those who are not yet seniors, who help pay the health bills of their parents or their grandparents, who also, frankly, are paying into the-not only the hospital insurance, but indirectly into Part B.

Thirty-eight years ago, Harry Truman signed legislation creating Medicare, and here we are in 2003 making a huge, major advance, almost a leap forward, improving Medicare and bringing Medicare up into this century. And I'm extremely proud to be part of that.

In addition, it's important to remind all of us that nothing of major consequence passes in this body unless we work together, unless there's teamwork. And you see here, standing behind the podium here, several of us who were part of the team, but there are so many others, too, who helped work to put this together, extremely complicated, very, very difficult, at times acrimonious, at times almost impossible to put pieces together, but we found a way to do it. I won't list all the names here because once I start, I know I'll forget someone. But it's a huge advancement for Medicare. I'm proud to be part of it.

And seniors will see-mark my words-seniors will see that the benefits of this bill are extraordinary. It will take a few years for them to come into effect, but when they go into effect, then seniors will see the very, very significant benefits of this bill and be very proud of their Congress.

SEN. BREAUX: Let me first of all congratulate all of the people who have worked so hard and so long on this legislation, particularly our staff from both sides of the aisle, who spent countless hours, days, evenings, nights and weeks trying to craft a piece of legislation that indeed is very historic.

Today is not the day to argue about which political party has won and which political party has lost. This is a day to celebrate a great victory for America's 40 million seniors, who for the first time will have something that they have argued for for decades.

I think it is important to note that this is an important victory for, I think, a center-out coalition in the United States Senate, which necessarily left people on the far left and the far right not necessarily part of the team, but a center-out coalition that has produced a balanced piece of legislation that is truly reform. I would hope that that type of organization, that type of political coming together will be able to accomplish other major issues that need to be addressed in the health care issue for the uninsured in the upcoming year.

For those that say that this is the end of Medicare as we know it, let me suggest that this is the end of a Medicare program that does not cover, on average, 47 percent of the cost of health care for the average senior. For those who say it's the end of Medicare, let me suggest that this is the end of a Medicare program that forces seniors to choose between food on the table or drugs that they desperately need. For those who say it's the end of Medicare, let me suggest that it is the end of a Medicare program that discriminates against poor seniors by requiring them to stay in an uncertain state Medicaid program.

Let me suggest, finally, that it is, however, the beginning of a new and reformed Medicare program for the 21st century, that we who are fortunate enough to live in a great nation can be justifiably proud of.

SEN. SNOWE: Well, with today's Senate vote, we are ushering Medicare into a transcendent new era as we revolutionize the program with the single-largest enhancement in is 38-year history. Obviously, this is a transformational chapter in the Medicare program, because we will no longer be returning to the days when Medicare lived in the Dark Ages, totally oblivious to the remarkable drugs that are available to prevent death, to halt disease, to prevent the progression of disease. And no longer will we be returning to the days when our nation's seniors have no prescription drug coverage whatsoever, struggling to pay for those costs-the medications that can make the difference between the quality of life and life itself.

Obviously, there are many to thank in this process, and I do want to express my gratitude to Chairman Grassley, whose efforts I described as nothing short of Herculean in his perseverance and his dogged determination, his commitment to get it done. To Ranking Member Baucus, who was willing to reach across the political aisle to forge an agreement to get this done and to achieve a legislative victory for our nation's seniors.

And, of course, to execute this extraordinary achievement, we have a great deal of thanks to owe the Senate majority leader. I think it's a testimony and tribute to his deft and able leadership skills, not to mention his unparalleled knowledge of the issue, and his devotion and commitment, and his single-mindedness to accomplishing this on a bipartisan basis.

And, of course, we couldn't have done it without the driving force of the president, who gave necessary impetus to this issue in Congress by making this prescription drug issue a cornerstone of his agenda.

Of course, I hearken back to the days of the tripartisan bill, with Senator Breaux and Senator Hatch and Senator Jeffords, along with Chairman Grassley, when we forged that agreement that really established the benchmarks, the critical benchmarks that are now included in this conference report, that ensure that a prescription drug benefit would be universal, that it would be affordable, that it would be mandatory, that it would be comprehensive, that we would have choices, that it would be equal benefits across all plans, and that we would also have a fallback mechanism to ensure that seniors would have access to prescription drugs regardless of where they lived in America.

So it is the portrait of what is possible, and I know some will say it doesn't live up to our aspirations or our expectations. But you have to measure this conference report against the fact that millions and millions of seniors will benefit, against the stagnation of the status quo. As I was quoting on the floor that you can-you sometimes have to fight a battle more than once to win it. Well, there have been many battles in many years, and the question is, how many battles and how many years would it take to achieve this victory if we had failed to do so today, and at whose expense?

This is our last best opportunity to be able to get a legislative foothold so that we can secure, once and for all, and for the first time, assistance to all of our nation's seniors, but most especially the 10 million Medicare beneficiaries who have no coverage whatsoever currently, and for the 14 million seniors who come under the cap of 150 percent of poverty level.

Now we know that we can't get it done without compromising, and again, it goes back to the leader's goal at the outset of this process to make this a bipartisan package. You can't get things done in the United States Senate without compromising, because of the cloture votes, as we know, and because of the narrow margins.

Finally, this conference report puts an end, as Senator Breaux indicated, to the open-ended privatization proposal that was in the House, that would have used the premium support plan that has been untested and untried, that clearly could have undermined the traditional fee-for-service Medicare program.

Obviously, Medicare has withstood the test of time, and I think we have an obligation to ensure that any new ideas and any new options should also withstand the test of time, so that we can guarantee that seniors will continue to have a quality health-care plan for the same price universally across America.

Thank you.

SEN. FEINSTEIN: About two weeks ago, I was sitting in the Judiciary Committee when Chuck Grassley came in and sat down. And I could see the strain all over this face. His face was white, his mouth was down-turned, and you could just see the strain of the negotiations that produced this bill.

I just want to begin by thanking Mr. Grassley; certainly the two Democrats that worked on this-Max and John; and the Republican leader for pushing this bill.

This was not an easy vote for me. I come from California. It's a state where Medicare is closely held; feelings run deep, they run passionately. And yet, as I began to look at the specifics of the bill, it became pretty clear that the very things over the last 10 years that people have come to me for are contained in this bill.

The first was a prescription drug plan. "Please, we can't keep going in a high cost-of-living state," seniors would tell me, "not being able to go in and purchase a food item because we needed to spend it on medication." And a year ago, when we did the numbers, plan after plan after plan, we couldn't get the low-income benefit as good as it was, or the doughnut hole-so called-as small as it was, as this bill manages to do. For me, the low-income coverage and the catastrophic coverage make this a good prescription drug plan.

Now, I know there are doubters out there. I know there are people saying, "We don't like it." And all I say to them is give it a chance to work; give it a chance to work. The drug discount card goes into play next year. It takes a period of time for the prescription drug plan to go into force -- 2006.

Then secondly, I would hear from county hospital after county hospital-Los Angeles, San Francisco, every other one-"We need more disproportionate share payments." This bill provides it.

Then I would hear from hospitals, one after another, over two dozen, nearly 36 hospitals that closed in the time I've been in the Senate, "Please, we can't make it with the payments we have." And this bill helps there.

Thirdly, 10 to 12 percent of retirees are being cancelled from private retirement plans a year. This reduces the numbers dramatically because it puts money in it to help companies maintain these plans.

And then finally, those people who are dually eligible-and in California, the Medicaid assets test is very stringent-the assets test here is much more relaxed.

Consequently, 351,000 poor seniors in my state who are not allowed to buy their benefits through Medicaid will be able to-their prescription drugs-will be able to do it through Medicare.

The one weakness in this bill-and there are things I don't like about it, but the one major weakness, I think, that we have to watch out very carefully for is cost containment of drugs. The theory of the bill is that private-sector competition will drive down the price of drugs. And that may happen and it may not happen. The CBO numbers project that it will happen, and will happen rather dramatically over virtually every other bill that's been proposed. But we need to watch that. And we will. And I really feel confident that the leadership will make changes if the cost containment numbers are not kept.

So I voted for the bill, and I voted for it for one reason, because I truly-in my heart of hearts-believe that seniors in my great state are going to be better served by this bill than they are under the present system.

SEN. FRIST: Thank you. And very well said by everybody who has joined us here today.

We'll be happy to take a few questions. I know there's another conference-press conference to follow here.

Q Which has a different opinion.

SEN. FRIST: Yeah. Maybe we ought to stay here. (Laughter.) Not let anybody hear the other side.

There are people who are not here-just very briefly, the people who are not with us that we need to thank, because this will really be the last opportunity. Everybody's ready to go and get out for the holidays.

President Bush. Clearly, his leadership in making this a very, very high priority allowed us to rally behind a vision of affordable prescription drug coverage, at the same time modernizing health care. That vision is one that we could follow. We did it in a bipartisan way in the United States Senate, and we've all expressed the importance of that, reflected in the vote.

Someone who is not with us but who was chairman of the conference committee, Chairman Bill Thomas. He's a remarkable individual. I want to mention him because without his leadership, his ability to assimilate very complex ideas and put them together, and in this conference in a very bipartisan way, this legislation simply would not be possible.

I also want to thank Speaker Hastert and Majority Leader Tom DeLay. In the final couple of weeks of this legislation, they worked with our leadership and together we made this the-among the highest priorities of the United States Congress.

And they have been very supportive of the conference work throughout, and without their involvement, again, I don't think that it would be possible.

I won't go and name all the conferees, but clearly Senator Nickles, Senator Kyl were instrumental in the conference itself and bringing this bill to fruition.

With that, we'll be happy to take a few questions.

Q Mr. Leader, are you concerned that even though this bill -- (inaudible) -- that they may be resistant just because change is involved and it may involve doing things a little bit differently, and that they may be very upset about this in a few years, even though -- (inaudible) --

SEN. FRIST: Because the great thing about this bill is that the choices, the options for health care plans that may better suit one's needs, the option for prescription drugs, are just that. They're options. They're alternatives. They're choices. Nobody's forced to do anything they don't want to do, which is very different than other proposals in the past.

What we've seen over the last three days is a real education process on the floor of the United States Senate-not very popular to be in all day Saturday, all day Sunday and all day Monday. And people have worked very hard. But what we've seen is a real education process, and as people learn and look at really what's in this bill, people are comfortable with it, and I think the seniors will be the same.

So no, this bill is so advantageous to seniors that I think that once they see it, once they see the benefits, that it will be very popular.

It's going to be tough. I mean, this is very complex. So it's going to be tough in the sense that we are going to have to provide strong oversight. Issues like cost containment, issues like setting up the PPOs in a satisfactory manner-it's going to take a lot of hard work on all of our parts.

SEN. BAUCUS: Can I just, on that question --

SEN. FRIST: Yeah. Yeah.

SEN. BAUCUS: I think it's very important. Seniors are naturally skeptical. We all know our parents, grandparents, you know, tend to wonder. "Oh, yeah, I've seen that before," and all that kind of a thing.

But because fee-for-service is held harmless in this legislation, and because fee-for-service Medicare is strengthened in this legislation, and because seniors always will be able to stay in regular fee-for-service, regardless, I think in the next, you know, year or two, when they learn what this is all about and knowing that there's the comfort of falling back on their basic plan, that they'll find that this is a pretty good bill, and particularly when it starts to give them some very significant benefits.

But the initial skepticism is natural. It's just going to take a little bit of time for people to realize what's in the bill.

Q Mr. Leader, Senator Gregg and others talked about the fact that the scoring was only over --

SEN. FRIST: (Indicating Senator Baucus.) This guy's tough. Look at his eye.

Q Yeah.

SEN. FRIST: Look at that. Fifty miles. Has anybody listening to me run 50 miles? Nobody. Nobody.

SEN. BREAUX: Fifty miles in the caucus.

SEN. FRIST: Fifty miles. Sixth mile cut, blood coming down. He toughed it out! (Laughter.) No stitches, no-if I were there --

SEN. BAUCUS: No, that wasn't there. It was in our caucus.

SEN. FRIST: (Laughs.) That's right.

(Laughter.) It wasn't that tough.

SEN. BAUCUS: Right.

SEN. FRIST: Fifty miles!

Yeah. Sorry.

(Cross talk, laughter.)

Q To pay for this long-term, the scoring was only over 10 years, 400 billion (dollars), but when the baby boomers start retiring in 10 years, the costs could explode. What --

SEN. FRIST: The hope for the huge demographic shift, the tidal wave that's inevitable, the driving force, really, behind this bill, in that we can have a doubling of the number of seniors and almost half the number of people supporting them, is that this bill, by having a level playing field with appropriate competition in terms of quality and cost, where there's full transparency, that we will be able to sustain this program in a way that is-which, without question, could not be done without the new bill, without change.

As currently constructed, the bill-because of the demographic shift, it simply could not face this tidal wave, so what we've done in this bill is inject elements of the marketplace-of competition, of purchasing by plans in bulk quantity, of engaging in things like risk sharing in the competitive model-which we haven't talked very much about. These dynamics of the marketplace are what we believe is most suitable, at the same time guaranteeing seniors the benefits that they have today and adding benefits to it.

Q Senator Frist, Medicare Plus Choice has not worked as it was envisioned. What if private plans don't come to this plan and don't offer the benefits? What does that mean for seniors? What does it mean for for the government?

SEN. FRIST: Medicare Plus Choice. First of all, there are 35 million people in traditional people. There are 5 million people in Medicare Plus Choice. And the people in Medicare Plus Choice are very pleased with the health care that they get today. So it's not a matter of the plans not working. They have coordinated care, they have disease management, they have prevention and they have prescription drugs. Traditional Medicare doesn't have any of that.

So if you talk to the 5 million people, the reason they haven't grown is really our fault. We put a huge administrative burden on them, and we've learned from it And in this current bill as we set up other types of plans, we won't have that administrative burden. And we under-reimbursed them. We didn't pay them sufficiently, and therefore, they didn't grow over time. Both of those-and we had the advantage of learning from the-not the mistakes that were made, but the reasons they haven't just taken off And we've incorporated what we've learned into those bills.

Q Senator Frist, you've emphasized this is a bipartisan bill, but do you think that this represents a victory for Republicans in the sense that you've loosened the grip of Democrats on -- (off mike) -- policy?

SEN. FRIST: Yeah, this is-boy, everybody keeps trying to come back to the partisanship, and that's why I keep coming back to the bipartisanship. The victory is not for Republicans, the victory is not really for the president of the United States, the victory is not for the Democrats, the victory is just for the American people. And it's just for seniors; it's for those 77 million baby boomers and all of us who will be seniors in the future. This is clearly a victory for the American people, not either party.

Thank you very much.